Search

Competing Interests: HC, SH, and SPR are the Co-Chairs of the Lancet Commission on Medicine, Nazism, and the Holocaust, VR was a Co-Chair of this Lancet Commission until September, 2021, and the other authors are members of this Lancet Commission. TC has received honoraria and travel support for lectures, presentations, and educational events about medicine, Nazism, and the Holocaust from academic institutions only. HC has received travel funding for a Lancet Commission meeting in Jerusalem (2022) and a grant from the Max Planck Society for a project on the history of brain research using Nazi victims' brains. MAF has received funding from the Israel Medical Association for leading seminar tours on medicine and the Holocaust. SH has received royalties from Berghahn Books for The Anatomy of Murder, honoraria from educational institutions for lectures about medicine and anatomy in Nazi Germany, and is an unpaid member of the Harvard Human Remains Research Review Committee and the American Association for Anatomy Task Force on Legacy Collections. EL has received royalties from Classiques Garnier for his book L'Homme, cet inconnu d'Alexis Carrel (1935), serves as an unpaid member of the Israel National Commission according to the Patient at end-of-life Law (2005), and received travel reimbursement for attending a symposium at Cedars Sinai Center for Medicine, Holocaust and Genocide Studies (Los Angeles, CA, USA) and the Lancet Commission meeting in Vienna (2023). MO has received occasional honoraria from educational institutions for lectures on medicine, Nazism, and the Holocaust at educational institutions, as well as travel reimbursement for the Lancet Commission meetings in Jerusalem (2022) and Vienna (2023). AO declares travel reimbursement for attending the Lancet Commission meeting in Vienna (2023). VR received a grant for a project financed by the Max Planck Society on the use of body parts of Nazi victims in brain research. MR received a contract from the district of Upper Bavaria for research and a book project on victims of National Socialist euthanasia starting in October, 2023; received travel reimbursement for presentations on psychiatry in Nazi Germany at educational institutions; and serves as an unpaid member on the advisory boards for Brandenburg memorial sites, Hadamar memorial site, Irsee memorial site, Klingenmünster Psychiatric Hospital, the Bernhard Nocht Institute, the German Society of Pediatrics and Adolescent Medicine, the German Association for Psychiatry, Psychotherapy and Psychosomatics, and the Hessian Ministry of Science. CS received an honorarium from the Max Planck Society (work contract) for participation at the Lancet Commission meeting in Vienna (2023). SJS received travel reimbursement from the Cedars-Sinai Center for Medicine, Holocaust and Genocide Studies for attending the Lancet Commission meeting in Vienna (2023) and has received honoraria from educational institutions for presentations on medicine, Nazism, and the Holocaust. AT has received royalties from Cambridge University Press for the book Social Mendelism: Genetics and the Politics of Race in Germany, 1900–1948, and an honorarium from the University of Leeds (Leeds, UK) for a lecture titled “Mendeling Jews: a history of racial genetics”. HSW has received honoraria from educational institutions for presentations on the legacy of medicine during the Holocaust and professional identity formation. MKW has received a grant from the Macy Foundation for the implementation of this Lancet Commission's first teacher training fellowship; has received honoraria from educational institutions for lectures on medicine and the Holocaust, which he donates to his institution's fund to support programmes related to this history; serves as Co-Chair of the American Medical Association's Truth, Reconciliation, Health and Transformation Task Force (for which he receives an annual honorarium that he donates to his university); and is an unpaid member of the Fellows Council for the Hastings Center and the Advisory Council for Physicians for Human Rights. All other authors declare no competing interests.

Competing Interests: Declaration of interests TC has received honoraria and travel support for lectures, presentations, and educational events about medicine, Nazism, and the Holocaust from academic institutions only. HC has received travel funding for a Lancet Commission meeting in Jerusalem (2022), and a grant from the Max Planck Society for a project on the history of brain research using Nazi victims' brains. MF has received funding from the Israel Medical Association for leading seminar tours on medicine and the Holocaust. SH has received royalties from Berghahn Books for The Anatomy of Murder, honoraria from educational institutions for lectures about medicine and anatomy in Nazi Germany, and is an unpaid member of the Harvard Human Remains Research Review Committee and the American Association for Anatomy Task Force on Legacy Collections. EL has received royalties from Classiques Garnier for his book L'Homme, cet inconnu d'Alexis Carrel, 1935, serves as an unpaid member of the Israel National Commission according to the Patient at end-of-life Law (2005), and received travel reimbursement for attending a symposium at Cedars Sinai Center for Medicine, Holocaust and Genocide Studies (Los Angeles, CA, USA) and the Lancet Commission meeting in Vienna (2023). MO has received occasional honoraria from educational institutions for lectures on medicine, Nazism, and the Holocaust at educational institutions, as well as travel reimbursement for the Lancet Commission meetings in Jerusalem (2022) and Vienna (2023). AO declares travel reimbursement for attending the Lancet Commission meeting in Vienna (2023). VR received a grant for a project financed by the Max Planck Society on the use of body parts of Nazi victims in brain research. MR received a contract from the district of Upper Bavaria for research and a book project on victims of National Socialist euthanasia starting in October, 2023; received travel reimbursement for presentations on psychiatry in Nazi Germany at educational institutions; and serves as an unpaid member on the advisory boards for Brandenburg memorial sites, Hadamar memorial site, Irsee memorial site, Klingenmünster Psychiatric hospital, the Bernhard Nocht Institute, the German Society of Pediatrics and Adolescent Medicine, the German Association for Psychiatry, Psychotherapy and Psychosomatics, and the Hessian Ministry of Science. CS received an honorarium from the Max Planck Society (work contract) for participation at the Lancet Commission meeting in Vienna (2023). SJS received travel reimbursement from the Cedars-Sinai Center for Medicine, Holocaust and Genocide Studies for attending the Lancet Commission meeting in Vienna (2023) and has received honoraria from educational institutions for presentations on medicine, Nazism, and the Holocaust. AT has received royalties from Cambridge University Press for the book Social Mendelism: Genetics and the Politics of Race in Germany, 1900–1948, and an honorarium from the University of Leeds (Leeds, UK) for a lecture titled “Mendeling Jews: a history of racial genetics”. HSW has received honoraria from educational institutions for presentations on the legacy of medicine during the Holocaust and professional identity formation. MKW has received a grant from the Macy Foundation for the implementation of this Commission's first teacher training fellowship; has received honoraria from educational institutions for lectures on medicine and the Holocaust, which he donates to his institution's fund to support programmes related to this history; serves as Co-Chair of the American Medical Association's Truth, Reconciliation, Health and Transformation Task Force (for which he receives an annual honorarium that he donates to his university); and is an unpaid member of the Fellows Council for the Hastings Center and the Advisory Council for Physicians for Human Rights. All other authors declare no competing interests.

At the Wiesbaden Internist Congress of 1949, Alexander Mitscherlich and Viktor von Weizsäcker called for an expansion of the scientific concept of causality to include the search for the meaning of illness in one's personal history. This called into question a traditional psychiatric paradigm which presumed somatic causes of mental illness. Additionally, common psychiatric evidence practices were put to the test. In the first part of this article, three psychiatric positions that were presented at the 1949 congress are reconstructed. In the second part, the development of one of the psychiatrists involved, Jürg Zutt, is examined by focusing on the question of the possible effects of the Wiesbaden debate on his scientific reorientation as well as its consequences for his view of psychiatric evidence., (© 2021. Springer Nature Switzerland AG.)

During World War II, psychiatric patients hospitalized in asylums in Eastern Prussia became victims of two separate killing programmes: first, by the SS-special command Lange, second by the centrally (in Berlin) organized "euthanasia"-"Aktion T4". By an analysis of the patient files of the victims, the present paper shows that the historical actors responsible for the killings were communicating with each other. It is now also possible to reconstruct the exact dynamic in time and space of the killings. A comparative analysis of the selection criteria within the total population of the asylums documents that in both programs, the responsible historical actors included physicians and provincial administrative personnel; it further shows that under the conditions of war, only patients who were able to contribute to the asylum work and economy, and were behaviourally adapted could survive.

Ernst Rüdin (1874-1952), director of the Deutsche Forschungsanstalt für Psychiatrie in Munich, was one of the leading psychiatrists in Nazi Germany. Prevailing historical research on Rüdin's relation to the systematic annihilation of psychiatric patients is dominated by the only hitherto available biographical account which suggests that Rüdin privately disapproved of the "euthanasia" program, but did not make this disapproval public. According to this account, neither Rüdin nor any of his co-scientists were in any way actively involved in the systematic killings. In contrast to this image, a general evaluation of the historical sources on the systematic killing of patients clearly shows that due to the fragmentary character of the evidence, any exculpation of particular individuals or institutions is premature to date. Furthermore, the reevaluation of already known archival material and new documents presented here proves that Rüdin had a genuine interest in research which on the one hand made profitable use of the killings, and on the other hand was aimed at formulating scientific criteria for the systematic selection and "euthanasia" of those supposedly unworthy to live. Julius Deussen (1906-1970), since 1939 head of the department for hereditary psychology at the Deutsche Forschungsanstalt, was also a close co-worker of Carl Schneider (1891-1946) at the University of Heidelberg. He coordinated the research on children carried through in the context of the "euthanasia"-programme between 1943 and 1945. This research sought to systematically correlate clinical and laboratory findings with the histopathological data of the victims' brains. From the beginning, it included the killing of the patients. Central elements of the research programme had been formulated by Deussen already in Munich. Rüdin supported the activities of Deussen in Heidelberg and repeatedly pointed out that they were of importance for the health and population policy of the Nazi regime.

The history of German psychiatry is characterized not only by innovative thought in the tradition of Kraepelin and Jaspers, but also by the "euthanasia" program that resulted in the killing of more than 100,000 psychiatric patients and mentally handicapped people. Exemplified by the Psychiatric Department at the University of Heidelberg, the relation between psychiatric research and the systematic killing of patients during the time of National Socialism is analysed. The first part of the paper summarizes the historical background of the general condition of German psychiatry in the 1930s and 1940s. The second part gives an outline of the biography and work of Carl Schneider (1891-1946), head of the Psychiatric Department at Heidelberg until 1945. It can be shown that the call for intensive therapy for those patients who were to be reintegrated into society was connected with the killing of those who were considered to be beyond reach of any active therapeutic approach. This is also the context of C.Schneider's research program concerning mentally handicapped children. The historical reconstruction of research activities, drawing on the patients' files and other documents, reveals that out of 52 children who had been examined, 20 were killed in the asylum of Eichberg in order that their brains might be examined in Heidelberg. The findings are discussed in view of the ongoing historiographical debate on the relationship between the politics of National Socialism and contemporary science.